干预前后普外科围术期抗菌药物应用分析

目的：了解干预前后我院普外科围术期抗菌药物使用情况,探讨临床药师在普外科围术期预防性应用抗菌药中的作用,为临床合理用药提供参考。方法：选取普外科临床药师深入参与临床药物治疗前后腹股沟疝修补术出院病例,对围术期抗菌药物预防性应用合理性进行分析评价,以考查临床药师的工作效果。结果：干预后腹股沟疝修补术抗菌药物使用率由96%（96/100）降至39%（39/100）（P〈0.05）,抗菌药物合理使用率由5%（5/100）升至69%（69/100）（P〈0.05）;围术期不合理应用抗菌药物的表现形式均有不同程度改善;平均药费、抗菌药物费用下降显著（P〈0.05）。结论：我院临床药师深入临床,采取多种技术手段有效干预围术期预防性应用抗菌药物,极大提高了抗菌药物合理应用水平,为下一步开展临床路径与单病种的药学服务模式提供有益的参考。

Perioperative Antibiotic Use in Patients from Department of General Surgery before and after Intervention

OBJECTIVE：To investigate the perioperative antibiotic use in patients from the Department of General Surgery before and after intervention, discuss the role of clinical pharmacists played in perioperative use of prophylactic antibiotics in Department of General Surgery so as to provide references for clinical rational use of antibiotics. METHODS： The patients who have been discharged from hospital after undergoing inguinal herniorrhaphy were sampled for evaluation of the rationality of perioperative use of prophylactic antibiotic use before and after clinical pharmacist＇ involvement in these patients＇ medication in an effort to investigate the intervention outcome of clinical pharmacist. RESULTS： After intervention from clinical pharmacists on medication for patients undergoing inguinal herniorrhaphy, the rate of antibiotic use decreased from 96% （96/100） to 39% （39/100） （P 〈0. 05）, and the rate of rational antibiotic use rose from 5% （5/100） to 69% （69/100） （P 〈 0.05 ） ; all manifestations of the irrational perioperative antibiotic use improved to different degree; the mean drug cost and mean antibiotic cost decreased significantly （P 〈 0. 05 ）. CONCLUSION： The clinical pharmacists＇ in-depth involvement in patients medication by taking multiple technical means during intervention on perioperative use of prophylactic antibiotics resulted in great improvement in rational use of antibiotics, which provided helpful references for further developing clinical pathway and single-disease type pharmaceutical care models.